How Done: Five years after the research that was the basis for Human Sexual Response was begun, a clinic was established where the researches' findings could be utilized--used, that is, to treat couples with sexual problems. Two co-therapists, a man and a woman--either Masters and Johnson or their "2nd team"--conducted the therapy, which was based on the premise that any marital sex problem involves both partners, and therefore it is the relationship, not one individual, that requires treatment. One revolutionary aspect of the therapy was its emphasis on the "here-and-now," rather than the excessive probing of the past considered essential by traditional therapists.

Initially, the co-therapists alternately interview both partners and take their histories, developing an idea of the patients' philosophies and life-styles. Physical examinations and laboratory tests are made. On the 3rd day, patients and therapists discuss the findings so far. The concept of "sensate focus" is explained "communication by touching," considered by Masters and Johnson to be the most important source of sexual stimulation. The partners are taught "sensate exercises"--massage, fondling, stroking, etc., but without specific genital stimulation. This "pleasuring" is repeated on the 4th day, this time with the genitals included. The idea is to develop a set of sensory signals between the partners. Charts and models are used to explain the anatomy of sex to the couple; a surprising number of husbands had never seen their wives' genitals.

On the 5th day, treatment of the specific problem begins. The most common of these are premature ejaculation, impotence, orgasmic dysfunction, painful intercourse, and problems relating to aging. Since each couple is different, there is no rigidly structured program. The most sensational aspect of the therapy was the use of 13 "partner surrogates"--all unmarried women, not prostitutes--to help in the treatment of 41 impotent men.

No case is considered a success until the end of an unprecedented follow-up period of 5 years.

Subjects Studied: For this survey, 790 patients were referred by psychiatrists and other counselors. Some represented both sides of a marriage (of 510 couples, 223 had dual sexual distresses, making a total of 446 patients in this category); 287 represented the "suffering" partner in a marriage; and there were 54 unmarried males and 3 single women. most were American, some Canadian, about 12% living in St. Louis. All were middle-class and above, with 72.7% having had some higher education. More than half paid the $2,500 fee (per couple) for the treatment, which lasted 2 weeks. Others paid less, some nothing at all. Since most patients also had travel and hotel expenses, they were obviously highly motivated.

Where Done: Begun at Washington University in St. Louis, it was moved to the Reproductive Biology Research Foundation in the same city in 1964. Sessions were conducted by the therapists at the clinic during the day, with the patients doing their "homework" at night, per the therapists' suggestions, at their homes or hotels.